In 2008, The Colorado Trust announced a new focus for its grantmaking. Through an intensive planning process, we identified opportunities to continue The Trust's long-held mission of advancing the health and wellbeing of the people of Colorado, while more purposefully focusing on a single vision: Achieving Access to Health for All Coloradans by 2018.

This year's annual report is longer than usual as we felt it important to share in some depth the thinking behind our 10-year vision. On the following two pages, we provide an at-a-glance overview of the major barriers and challenges to achieving access to health, as well as the main strategies we are supporting to expand health coverage and to increase and expand health care. This is followed by a detailed look at many of the complex problems within our health care system and the associated Trust strategies. As well, we are pleased to include four thoughtful essays from dedicated Coloradans working hard to improve the provision of quality, affordable health care and coverage, together with hopeful stories of change and improvement from our grantees.

While we have put a lot of thought into the development of these strategies, we recognize that this long-term effort will, by necessity, evolve over time in response to our economic ups and downs, as well as a changing policy and social environment. This was underscored as the recession hit soon after we announced our first funding efforts in support of achieving access to health. This unprecedented economic drop is causing deep stress on families, nonprofit organizations and the government. The biggest challenge is that at the same time workers are losing their jobs and their health care, the government, the business sector and foundations have diminished resources to address increased needs. On the flip side, a positive may well be that the deficiencies of our poor system of health coverage and care have been further exposed and are becoming increasingly difficult to deny.

We know that solving the challenges of access to health for all Coloradans cannot be accomplished by The Colorado Trust alone. Clearly this level of change requires a collaborative approach involving all sectors of society, including individuals, public and private organizations, and the government. Thankfully there are many stakeholders working to address health needs in Colorado.

The bottom line is that good health creates opportunities for a good life. Without good health, we cannot receive a solid education, obtain employment or contribute to our communities.

We believe the time has come to address the full extent of the problem and remain focused until we have realized access to health for all Coloradans.